Noninvasive three-dimensional computed tomographic angiography in preoperative detection of intracranial
1Department of Neurosurgery, Huashan Hospital, Shanghai Medical University, Shanghai 200040, China. wjsongc@online.sh.cn
Objective:
To assess the value of noninvasive three-dimensional computed tomographic angiography (3D-CTA) in preoperative detection of intracranial arteriovenous malformations (AVMs).
Methods:
A prospective evaluation at a single institute over a 2-year period included 23 patients suspected of intracranial AVMs. All patients underwent 3D-CTA and digital subtraction angiography (DSA). Results from both procedures were compared.
Results:
3D-CTA imaging provided excellent visualization of intracranial AVMs. The false positive error and false negative error were zero in our sample. The details of arterial supply (numerical measure, orientation, caliber and routing) and vascular nidus (size, morphosis and location) provided by 3D-CTA images were the same as DSA and the details of venous drainage were an approximate match. Additionally, 3D-CTA can depict tridimensional anatomical information for AVMs and their relationship to adjacent structures, a function not possible with DSA. This assisted the surgeons in making better surgical planning and reduced trauma. As a noninvasive course, there were no related-complications in the course of 3D-CTA processing.
Conclusions:
DSA is still regarded as the gold standard for intracranial AVMs detection. The modality of 3D-CTA is accurate, noninvasive, nearly risk free and low-price; we could routinely use it instead of or as a supplement to DSA, in the preoperative detection of suspected intracranial AVMs and postoperative radiological follow-up. 3D-CTA adds tridimensional aspect and assists the surgeon in a the more accurate therapeutic scheme. Preliminary data suggest that 3D-CTA is playing a favorable role in the assessment of patients with intracranial AVMs.
